Ninety Percent Sure

Read: Risk VERY VERY Small

A few weeks ago, after so much waiting, a number of anxious phone calls and a spout of me crying in a small hospital room, we finally got the results of the pre-pregnancy genetics tests back.

On the test that screened for over 200 potential genetic problems, we discovered that Nathan and I are each carriers for one disease.  However, since it is not the same disease, the risk that we have an infected child is 1/4,400 (0.0227%) for one of the diseases and t 1/3,520 (0.0284%) for the other. 

As for the other genetic test for Nathan, the results came back with a 90% chance that he doesn't have the disease.  Combined with the fact that he doesn't meet the clinical criteria, the doctor felt pretty confident that he does not have it.  However, he did say that they could be even more sure if they compared the results with a blood test from a family member.

Now, this is where I feel I really had a triumph over my OCD tendencies.  Something I struggle with that is very common with OCD and anxiety is that I find it very hard to live with any doubt.  OCD feeds on doubt, and so you want to be 100% sure of everything.  This can lead to all sorts of unhealthy behaviors from checking and rechecking to unhealthily obsessing over horrible possibilities that have only a small remote chance of either being true or becoming true.

You have a feeling that somehow you will be on the wrong side of statistics.  If there's a 97% chance that something is good, it is very easy for someone with OCD like mine to focus on that lingering 3%.  The most ridiculous part is that this fixation on small chances and the feeling that the unlikely occurrence is sure to happen only acts up when considering improbable bad outcomes.  

For example, if someone told me there was a 2% chance I would die tomorrow, I would be very uncomfortable.  I would spend the whole day thinking I was going to hit that 2%.  I wouldn't feel any safety in the 98% chance that I would be okay - I would feel doomed.  But, if it was reversed and someone told me there was a 98% chance I would to die tomorrow, I wouldn't focus on the 2% chance of survival and feel a lot of hope.  It isn't about a misunderstanding of how numbers or chances work as much as constantly fearing the worst while also expecting it as unavoidable.

But when we got these results, I was satisfied.   The odds from the overall couples' screening were clearly astronomically small, but I even feel good about the 90% assurance on Nate's major test.  I heard the results and didn't want to keep digging.

I know we can never with 100% certainty prove the negative.  Even comparing the results to a family member's results, the doctor admits that they still could not make a 100% guarantee.  The truth is that seeking any assurance higher than 90% won't really make me feel any safer.  Starting a family means accepting a lot more risk in my life.  I know by now that the OCD fears and worries aren't going to magically disappear, but accepting these results and feeling good about moving forward was a step in the right direction.  

So, here's to moving forward even when you're only 90% sure.  Sometimes, that's the best thing to do. :)

Poetry & Mental Health

As an English major, I always enjoyed poetry - the way wordplay and rhythm can come together to make you smile, hurt, laugh and cry. Poetry often focuses on emotion, giving it a natural connection to mental health. Poems are such a unique way to connect with the experiences of the poet, and they can articulate feelings you may have trouble expressing yourself.  It can also be cathartic for the authors, as writing poetry becomes a type of therapy. (For more information on the therapeutic benefits of writing, check out this article from the American Psychological Association.)  

Recently, I came across two poetry books by Cleveland authors that delve into the gamut of human emotions: Angeline Walsh's Bad Psychiatry: and Other Aptly Themed Poems and Eric Dettelbach's Lyrics for Lucid Dreamers.  As a disclaimer, I am not being paid by either author to discuss these books.

Walsh is a young woman who contacted me after finding my OCD blog on Facebook.  Many of her poems touch on the pain of mental illness, but she also has poems that focus on hope and happiness.  Written over years (she told me that one of my favorite pieces, "Weathering it All," was written when she was just seventeen), her poems reflect the ups and downs of life.  While some were clearly written from a dark place, others reflect a joy of spirit.  

Dettelbach's book is not directly focused on mental health, but like Walsh's touches on the emotional highs and lows that come with moving through life.  He is actually a coworker of mine, and I helped him type up years of notes to put together his book.  It was interesting to see the different tones from poem to poem, again ranging from despair to delight.  His focus on relationships - from romantic encounters to the experience of adopting a dog - highlighted just how much our connections with others can impact how we feel and who we become.

Though these authors lead very different lives (different genders, ages, marital statuses), they share so much.  It's easy when we are going through a tough time or having a mental health issue to feel so alone.  I'm so glad there are writers out there putting their feelings into words and sharing these experiences that show how alike we all are.  We see their pain, but we also see their perseverance and growth.

Publishing a book - especially a collection of personal poems - takes guts. Letting yourself be vulnerable isn't easy, and I applaud them both for the triumph of putting themselves out there. 

When You Have to Fight Your Nature

Gus's nature? Take the burger. 
No regrets. No remorse.

We all have natural inclinations that we should fight against for our own good.  

These demons come in many different forms.  If you have OCD, one of yours may be naturally seeking out reassurance to combat self-doubt.  If you have anxiety, you may naturally jump to the worst conclusion in every situation. 

Whatever your demons are, building character involves the difficult process of learning to combat these internal signals to craft a better self.

With this in mind, I have realized that my dog, Gus, is honestly one of the most noble creatures I know.

Those who have met Gus or have heard of his antics may be surprised by this.  Gus has bitten 3 of the 4 members of my bridal party.  Gus snarls, guards his food, and barks at strangers. He has seen a behavioral therapist for his anxiety and paranoia, resulting in a regimen of anti-anxiety medication, and he still gets very ornery.

But Gus is growing.  This morning, I went to give him his kiss goodbye and I got snarled at.  I knew to back away, and I went to sit on a nearby chair where I knew I would not come across as threatening. Gus followed me, did some light angry nibbles on my hand, and then, still slightly snarling, jumped up on me for a hug.  

I was moved.

Some of you may read this and wonder how I could possibly view this as positive.  Here's the thing: Gus showed restraint.  You could tell that he was really trying to be good...  The mismatch of his snarls and his cuddles revealed the internal struggle between his natural inclination to attack vs. his desire to show love and not hurt his loved ones.

Now, you may accuse me of anthropomorphism, but I think this experience really highlights something important about judging human behavior.  Certain instincts vary from individual to individual, and how impressive it is for someone to abstain from a behavior really depends on that specific person's natural inclinations toward that behavior.  

Anger is a solid example.  Most people don't bite, but a lot of them yell.  Personally, I rarely have outbursts where I scream at the target of my rage. However, I know that there are people who really struggle not to snap at others whenever they are frustrated.  In my opinion, when those people don't yell at someone, it is much more admirable than when I do not yell at someone.

Another way to think about it? Imagine fresh, hot french fries.  There may be two people who decline to eat them, but if one of those people hates the taste of french fries, their act of restraint just isn't as commendable or meaningful.

Trying to fight our negative instincts is the only way we can stop them from controlling our lives.  Even small steps matter.  If you have an OCD fear of germs and manage to ignore your compulsion to wash your hands an extra time? You have fought a harmful instinct.  If your depression tells you to stay in bed all day, but you get up anyway? You have fought a harmful instinct.  If your eating disorder tells you to binge, but you stop after one plate? You have fought a harmful instinct.

Don't fall into the trap of thinking comparable actions require comparable strengths of character.  Context matters.  Evolving and becoming stronger means that you have to appreciate these little victories in your unique journey.  

Congratulate yourself on the small improvements.  The little actions add up.

This is how we grow.  This is how we triumph.